Cardiac magnetic resonance imaging has been shown to be one of the best technologies for the evaluation of cardiovascular pathologies. The broad application of this promising technology is expected to significantly improve the treatment of patients with heart disease in general and ischemic heart diseases in particular. However, widespread adoption of this beneficial technology has been held back by the lack of both software infrastructure and specific software sequences that take advantage of this infrastructure to provide a complete ischemic examination that can be performed rapidly in the clinical environment. The aim of this application is to develop a commercial robust cardio- vascular subsystem that will enable the broad application of this technology to the clinical realm. Specifically, during Phase I of this proposal, HeartVista will develop and test a cardiovascular software infrastructure that provides an integrated environment for rapid cardiovascular imaging. This package will include real-time evaluation of myocardial function under stress conditions, volumetric perfusion imaging, high-resolution examination of myocardial viability in real-time and high-resolution examination of the proximal coronary anatomy. We further expect to collect 40 patient examinations for feedback and analysis in anticipation of full productization. Under previous NIH grant support through Stanford University, we have established real-time rapid imaging sequences for the assessment of wall motion and perfusion. We have also established the utility and accuracy of rapid coronary imaging sequences for the assessment of proximal coronary anatomy. Our goal in this proposal is to integrate these methods into a robust ischemic heart disease system to realize the clinical potential of cardiac MRI in the evaluation of coronary artery disease. Generally, our methods concern obtaining adequate temporal and resolution, spatial coverage, and contrast production for stress imaging using customized pulse sequences hardware to reduce data acquisition time, developing pulse a underlying real-time imaging platform that allows the seamless real-time integration of receiver coil functions, sequences, and post-processing and display that optimizes the workflow for studying patients with ischemia. This proposal focuses on developing and validating this combined examination to provide the clinician a robust and intuitive complete ischemic evaluation package that can be performed comfortably in less than 1 hour. [unreadable] [unreadable] [unreadable]